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� APPLICA�ON FOR CONSTRU�ION PERMIT <br /> everett <br /> tM Eroryree� � <br /> CITV OF <br /> : everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEA�E PRINT <br /> 259-BB10 <br /> � ❑ DEMOLITION 1-1 COMBINATION I I BUILDING I I MECHANICAL I I PLUMBING ❑ SI(iN <br /> Eq� MAllAODRESS CILY 21P PIION[ <br /> v� �i� �l1 tl- � ��� L d� ZS�2^ �G1 U <br /> TENAMT MAIL�DDRESS dTV ilP PIIONE <br /> �RGNITEGTORDE516NER M�IIMDRE55 CITV ZIP PIIONf <br /> OENERALCONTRACTOR MMLAODRESS CI1Y 21P PMONE LIGENSEt <br /> MEPHMIICQGIX�iR�GTOR MAILADDRESS CIIY 2:P PHONE UCENSE� <br /> Nw w f..�� 'G� 31ia - !{<<c ,�}ve E�f �lXui ZCzi•S"33� N�r7"�r�d l37 KJ_ <br /> PLUMBINQGONTR�CTOR M�R�DD�E55 dfV ZIP �HONE LICENSEI <br /> CIASSOF WORK <br /> �NEW f 1 ADDITION I I AITEP'�TION I I qEPAIR I I DEMOUTION I I WO. OSiOVE/FRPL INSERT f I BUILDING RELOCATION <br /> TE�1�MT MIPROVEMENT OR INTENIOR PEMVuEL CNLV COt:IRe-�EI15DN ANU P110Nfi NO <br /> CONTRIICT PRIGE OF WORR: <br /> 2� 0✓ <br /> pESCRIBE WO�N AN�SOV�RE f007�6E INVOLVEO <br /> '..�,�n,au.. C,rs Fut N � iW l� <br /> rnoroseouseoFaui inc I HEREBY CERTIFY TH.4T I HAVE READ AND EXAMINED THIS <br /> f* � . l APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT.ALL <br /> �� �Ea�pe RIPTIJN OF ROPERTV MOWN BELOW OR ARACH fOUR COPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERN�NO THIS TYPE OF <br /> � WOHK WILI BE COMPlETEO WITH WHETHER SPECIFIED HEREIN OR <br /> , ioT BiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO QIVE <br /> � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTflUCTION.7HAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFOHM THE WORK FOR WHICH <br /> ' APP!ICATION IS MADE AND I COMPLY WITH THE STATE <br /> — CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGNAiUREOFCONif1RCTORORRUTHORIZED��ENi UATE <br /> -- X . /�4 t�h� / <br /> P110JECT ADDRE55 — <br /> APPUCAN7SQIYBUSMES UCEHSENO.ANDBUSINESSNAME <br /> PLUMBIN(i MECHANICAL ' � <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO� TYPE OF EOUIPMENT �E <br /> WATER CLOSET(TOILET) NC—A/HNDLG UNITS—H.P. � <br /> BATHTU6 ; FORCED AIR SVSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOW�R � CLOTHES DRYEnS � <br /> KITCHEN SINK 6 DISP ' VENTILATION FAN i <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRV TRAY ' WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAI ' METAL FIREPLACE 8 CHIMNEV ' <br /> ; FIREPLACE INSERT � <br /> DRINKING FOUNTAIN � <br /> � HEAT PUMP ' <br /> FLOOR DRAIN � <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLLADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � <br /> , <br /> � <br /> � <br /> � � <br /> � <br /> --�- — � <br /> � <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ PERMIT $ � <br /> TOTALFEE $ TOTALFEE $ C�i_ <br /> � PL/.NCHECKNUMBER FEE RECEIPTNO. <br /> FRONTSETB�CN REARSETBRCN SIDFSE7BAGN V I <br /> USEZONE �orAnen vncnNrsre FEES VALUATION FEE <br /> I 1 YES f I NO 6UIlDING ' <br /> TYPEOFLONS1.AlLUW�BLF iYCE0fC0'IS1ALiUFI IKYUPeM[r xCttm:lllixcUNn9 � <br /> cuouo p;UM01NG � <br /> � <br /> _ � <br /> SIZEOFBLDO. NO.OFSTO�IES OASE6IENT M:CHANICAL � <br /> I I YES I i NO ; <br /> OTHER ' <br /> OCLUPANCVIO�D FIPESPRNNLERSREO'� 11EIGHiLIMI��71ON i <br /> I.I YES I I NO S1AiE BUIIDING SURCHARGE i <br /> REASON FOR SPRINNLERS � <br /> STATEENERGYSURCHARGE � <br /> i <br /> APPIICAIION�CC.OV PLANSRPPROVEDBY CITYOFEYERETT PUBLICWORKS i <br /> IOCALSALES � <br /> TRX CODE IS 3105 TOTAL ' <br /> ,. <br />